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IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


1.0  :s 


I.I 


1.25 


112.8 


U^-   llllltt 

m 

m 


M 

2.2 
2.0 


1.8 


U    i  1.6 


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Hiotographic 

Sciences 

Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


is'A 


Q>< 


CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


H 


Canadian  Institute  for  Historical  Microreproductions 


Institut  Canadian  de  microreproductions  historiques 


1980 


Technical  i  ^d  Bibliographic  Notes/Notes  techniques  et  bibliographiques 


The  Institute  has  attempted  to  obtain  the  best 
original  copy  available  for  filming.  Features  of  this 
copy  which  may  be  bibliographically  unique, 
which  may  alter  any  of  the  images  in  the 
reproduction,  or  which  may  significantly  change 
the  usual  method  of  filming,  are  checked  below. 


U 


Coloured  covers/ 
Couverture  de  couleur 


□    Covers  damaged/ 
Couverture  endommagde 


D 


D 


D 
D 


D 


D 


Covers  restored  and/or  laminated/ 
Couverture  restaur6e  et/ou  pellicul6e 


□    Cover  title  missing/ 
Le  titre  de  couverture  manque 

□    Coloured  maps/ 
C 


artes  g^ographiques  en  couleur 


Coloured  ink  (i.e.  other  than  blue  or  black)/ 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noire) 


□    Coloured  plates  and/or  illustrations/ 
Planches  et/ou  illustrations  en  couleur 


Bound  with  other  material/ 
Reli6  avec  d'autres  documents 

Tight  binding  may  cause  shadows  or  distortion 
along  interior  margin/ 

La  reliure  serr^e  peut  causer  de  I'ombre  ou  de  la 
distortion  le  long  de  la  marge  intdrieure 

Blank  leaves  added  during  restoration  may 
appear  within  the  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certaines  pages  blanches  ajoutdes 
lors  d'une  restauration  apparaissent  dans  le  texte, 
mais,  lorsque  cela  dtait  possible,  ces  pages  n'ont 
pas  6t6  filmdes. 

Additional  comments:/ 
Commentaires  suppl6mentaires: 


L'Institut  a  microfilm^  le  meilleur  exemplaire 
qu'il  lui  a  6t6  possible  de  se  procurer.  Les  details 
de  cet  exemplaire  qui  sont  peut-dtre  uniques  du 
point  de  vue  bibliographique,  qui  peuvent  modifier 
une  image  reproduite,  ou  qui  peuvent  exiger  une 
modification  dans  la  mdthode  normale  de  filmage 
sont  indiquds  ci-dessous. 


□    Coloured  pages/ 
Pages  de  couleur 

□    Pages  damaged/ 
Pages  endommag^es 

□    Pages  restored  and/or  laminated/ 
Pages  restauries  et/ou  pellicul^es 

0''1>ages  discoloured,  stained  or  foxed/ 
Pages  d6color6es,  tachetdes  ou  piqudes 


I      I    Pages  detached/ 


D 


Pages  d6tach6es 

Showthrough/ 
Transparence 

Quality  of  prir 

Quality  indgale  de  I'impression 

Includes  supplementary  materif 
Comprend  du  materiel  supplementaire 

Only  edition  available/ 
Seule  Edition  disponible 


I  I  Showthrough/ 

I  I  Quality  of  print  varies/ 

I  I  Includes  supplementary  material/ 

I  I  Only  edition  available/ 


Pages  wholly  or  partially  obscured  by  errata 
slips,  tissues,  etc.,  have  been  refilmed  to 
ensure  the  best  possible  image/ 
Les  pages  totalement  ou  partiellement 
obscurcies  par  un  feuillet  d'errata,  une  pelure, 
etc.,  ont  6x6  filmdes  6  nouveau  de  fapon  d 
'-btenir  la  meilleure  image  possible. 


r~V^This  item  is  filmed  at  the  reduction  ratio  checked  below/ 

I  n/I    Ce  document  est  film6  au  taux  de  reduction  indiqu6  ci-dessous. 

10X  14X  18X  22X 


26X 


30X 


/ 


12X 


16X 


20X 


•Wi^ 


28X 


32X 


The  copy  filmed  here  has  been  reproduced  thanks 
to  the  generosity  of: 

National  Library  of  Canada 


L'exemplaire  filmd  fut  reproduit  grdce  d  la 
g6n6rosit6  de: 

Bibliothdque  nationale  du  Canada 


The  images  appearing  here  are  the  best  quality 
possible  considering  the  condition  and  legibility 
of  the  originel  copy  and  in  keeping  with  the 
filming  contract  specifications. 


Les  images  suivantes  ont  6t6  reproduites  avec  le 
plus  grand  soin,  compte  tenu  de  la  condition  et 
de  la  nettetd  de  l'exemplaire  filmd,  et  en 
conformity  avec  les  conditions  du  contrat  de 
filmage. 


Original  copies  in  printed  paper  covers  are  filmed 
beginning  with  the  front  cover  and  ending  on 
the  last  page  with  a  printed  or  illustrated  impres- 
sion, or  the  back  cover  when  appropriate.  All 
other  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impres- 
sion, and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


The  last  recorded  frame  on  each  microfiche 
shall  contain  the  symbol  -^  (meaning  "CON- 
TINUED "),  or  the  symbol  V  (meaning  "END"), 
whichever  applies. 


Les  exemplaires  originaux  dont  la  couverture  en 
papier  est  imprim^e  sont  filmis  en  commengant 
par  le  premier  plat  et  en  terminant  soit  par  la 
dernidre  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration,  soit  par  le  second 
plat,  selon  le  cas.  Tous  les  autres  exemplaires 
originaux  sont  filmds  en  commenpant  par  la 
premiere  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration  et  en  terminant  par 
la  dernidre  page  qui  comporte  une  telle 
empreinte. 

Un  des  symboles  suivants  apparaitra  sur  la 
dernidre  image  de  cheque  microfiche,  selon  le 
cas:  le  symbole  — »>  signifie  "A  SUIVRE",  le 
symbole  V  signifie  "FIN". 


Maps,  plates,  charts,  etc.,  may  be  filmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  diagrams  illustrate  the 
method: 


Les  cartec   planches,  tableaux,  etc.,  peuvent  dtre 
film^s  d  des  taux  de  reduction  diffdrents. 
Lorsque  le  document  est  trop  grand  pour  dtre 
reproduit  en  un  seul  clichd,  il  est  filmd  d  partir 
de  Tangle  sup6rieur  gauche,  de  gauche  d  droite, 
et  de  haut  en  bas,  en  prenant  le  nombre 
d'images  ndcessaire.  Les  diagrammes  suivants 
illustrent  la  mdthode. 


1 

2 

3 

32X 


1 

2 

3 

4 

5 

6 

OUR  RACE  AND  CONSUMPTIVES.* 


SIR  JAMES  GRANT,  K.C.M.G.,  M.D. 

Consulting  Physician  to  Their  Excellencies,  Lord  and  Lady  Minto ; 

Consultant  to  the  General  Hospital,  Water  Street  and 

St.  Luke's  Hospitals. 

OTTAWA. 


The  great  problem  staring  us  in  the  face  is,  What 
course  of  action  is  most  judicious  to  stay  the  spread  of 
consumption?  So  alarming  are  the  present  results,  that 
conferences  on  this  subject  are  being  held  in  mfost  of 
the  enlightened  centers  of  the  world. 

History  points  out  that  no  race  of  human  kind  has 
yet  obtained  a  permanent  foothold  on  this  continent. 
The  Asiatics  trace  back  their  life  history  so  far  that  it 
is  like  a  geologic  epoch.  Those  who  descended  from  the 
Ptolemies  are  still  found  cultivating  the  rich  alluvial 
banks  of  the  Nile.  The  race  that  peopled  Northern 
Europe  when  Greece  and  Rome  were  in  their  infancy 
still  retains  its  hold,  and  exercises  a  powerful  influence 
throughout  the  world. 

An  important  fact,  and  one  worthy  of  consideration,  is, 
that  races  have  been  born  on  this  continent,  lived  and 
entirely  disappeared,  leaving  as  records  of  their  past 
history  mounds  in  the  West,  vestiges  in  Florida,  and 
traces  in  other  directions,  which  give  an  undoubted  indi- 
cation of  at  least  two  extinct  races.  Thus  far  the  in- 
formation is  wanting,  which  would  clear  up  the  causes 
why  these  races  have  entirely  disappeared.  It  now  re- 
mains to  be  seen  if  the  Anglo-Saxon  race  will  prove  itself 
equal  to  the  occasion  and  be  more  fortunate  in  estab- 
lishing a  lasting  foothold  on  this  continent.     Climate 


*  Read  before  the  Canadian  Medical  AsBociatioi  i,  September,  1900. 


and  civilization  require  a  physique  and  brain-power 
equal  to  the  occasion  to  meet  successfully  the  trying  de- 
mands of  the  present  age. 

The  enthusiasm  of  the  Canadian  people  in  assisting 
in  the  protection  of  British  interests  in  South  Africa  was 
placed  beyond  doubt  by  the  rapid  equipment  of  fully 
3000  men,  who  entered  the  field,  and  displayed  bravery 
not  surpassed  in  the  history  of  the  Empire.  As  a  result 
many  valuable  lives  have  been  lost,  by  the  sword  and 
disease;  but  it  is  most  appalling  to  reflect  on  the  fact 
that  over  3000  deaths  by  consumption  were  recorded  in 
the  fair  province  of  Ontario  in  1898,  and  yet  our  people 
are  not  aroused  to  this  great  fatality,  now  assuming  such 
alarming  proportions.  The  seeds  of  this  disease  lurk  in 
our  country,  in  our  l.onio«,  in  our  places  of  business,  in 
the  food  we  eat,  in  the  water  and  the  milk  we  drink,  and 
in  the  air  we  breathe,  spreading  disease,  fatal  in  its  re- 
sults, and  producing  a  most  disastrous  influence  on  the 
present  generation. 

As  a  profession,  it  is  our  duty  to  guide  and  direct 
public"  opinion  as  far  as  possible,  in  order  to  place  the 
whole  subject  in  a  clear  and  comprehensive  form,  so 
that  common-sense  co-operation  may  be  aroused,  and 
an  active  interest  taken  by  all  classes  of  the  community, 
to  stay,  as  far  as  possible,  the  alarming  spread  of  con- 
sumption, the  "white  plague." 

For  many  years  medical  opinion  was  divided  as  to 
the  communicability  of  tuberculosis,  but  we  are  all  con- 
tagionists  now,  since  the  remarkable  discovery  of  Dr. 
Koch,  in  1882,  that  consumption  of  the  hmgs  is  caused 
by  the  introduction  of  a  living  germ,  the  bacillus  tuber- 
culosis, into  the  system  of  a  previously  healthy  person. 
To-day  his  theory  that  tuberculosis  is  a  communicable 
and  preventable  disease  is  accepted  and  verified,  two 
facts  which  can  not  be  too  strongly  impressed  on.  the 
public  mind.  Heredity  was  the  accepted  opinion  for 
many  years,  exercising  a  soothing  influence  on  some  by 
the  prospect  of  escape  from  consumption.  Nothing  is ' 
more  certain  or  conclusive  than  that  no  one  does,  or  can, 
inherit  consumption.  The  offspring  of  consumptive 
parents  receive  the  infection  from  without,  before  they 
can  become  consumptives,  thus  giving  fresh  hope  and 
spirit  to  the  parents  known  to  be  consumptive. 


a 


In  1888  and  1890  two  British  Hoyal  Commissions 
were  appointed  to  make  investigations  in  regard  to  tuber- 
culosis, and  the  result  of  their  deliberations  was  as  fol- 
lows ; 

1.  Consumption  is  a  contagious  disease. 

2.  Contagion  is  in  the  form  of  a  living  germ. 

3.  This  living  germ  can  grow  and  propagate  only  in 
the  body  of  man  or  some  of  the  lower  animals. 

4.  The  principal  source  of  infection  is  the  dried  ;^puta 
from  the  lungs  of  persons  already  suffering  from  tlie 
disease.  The  sputa  becoming  dry,  the  tubercle  germs 
float  as  particles  of  dust  in  the  air,  and  are  thus  in- 
haled. 

5.  The  other  source  of  infection  to  man  is  from  eating 
the  flesh  and  drinking  the  milk  of  tuberculous  cattle. 
Cooked  meat  destroys  infection,  and  is  not  as  dangerous 
as  raw  milk  containing  tuberculous  matter,  and  more 
particularly  if  the  animal  has  well-defined,  ulcerated 
udders. 

Dr.  Clifford  AUbutt*  has  published  the  opinion,  that 
there  are  instances  of  prolonged  use  of  tuberculous  milk 
by  many  persons,  old  and  young,  without  ill  conse- 
quences, and  this  immunity  depends  on  the  constancy 
of  the  defensive  machinery  of  the  body. 

In  189()  a  third  British  commission  was  appointed, 
composed  of  eminent  medical  men  and  veterinary  sur- 
geons, to  inquire  into  the  most  advisable  and  desirable 
means  for  controlling  the  danger  through  the  use  of  the 
meat  and  milk  of  tuberculous  animals.  "The  housing 
and  general  sanitation  of  cattle  require  special  care  and 
attention.  Tuberculin  should  be  supplied  free  by  gov- 
ernment to  all  owners  of  cattle,  so  that  their  herds  could 
be  examined  at  stated  intervals  by  the  tuberculin  test. 
The  infected  a,nimals  should  be  treated  according  to  the 
most  advanced  principles,  either  by  isolation  or  by  kill- 
ing. Local  authorities  ought  to  take  samples  of  milk 
offered  for  sale  within  their  districts,  and  vendors  should 
be  required  to  give  information  of  the  source  from  which 
the  milk  is  supplied."  These  methods  are  now  in  force 
in  England,  to  asist  in  stamping  out  "bovine  tuber- 
culosis," and  protecting  the  public,  as  far  as  infection  is 
concerned. 


1  British  Med.  Jour.,  Oct.  28, 1899. 


The  tuberculin  test  has  been  the  subject  of  considera- 
ble controversy,  and  the  following  facts  should  be  kept 
well  in  mind : 

Dr.  Watson*,  president  of  the  State  Board  of  Cattle 
Commissioners,  Concord,  N.  H.,  states:  "We  believe 
that  a  majority  of  the  cattle  reacting  to  the  tuberculin 
test  are  not  diseased  to  an  extent  that  requires  their 
slaughter  for  the  protection  of  the  public  health."  The 
policy  of  slaughtering  all  animals  that  reacted  on  tuber- 
culin has  been  entirely  abandoned,  as,  after  the  most 
careful  inquiry,  it  is  believed  that  a  majority  of  the 
cattle  reacted  on  by  the  tuberculin  test  are  not  diseased 
to  an  extent  that  requires  their  slaughter  for  the  pro- 
tection of  the  public  health.  Much  depends  on  the  care- 
ful and  thorough  examination  by  skilled  veterinary  sur- 
geons, as  thus  the  danger  of  infection  from  either  tuber- 
culous meat  or  milk  would  be  reduced  to  a  minimum. 

Tuberculin  does  not  reveal  the  degree  of  infection 
and  is  not  as  reliable  a  test  as  "as  at  first  supposed. 
Solomon,  in  1893,  admitted^  tha^,  tuberculin  was  a  great 
aid  to  diagnosis  of  tuberculosis,  bat  not  infallible,  and 
might  lead  to  errors.  There  are  instances  on  record  in 
which  tuberculosis  existed  and  the  animals  did  not  react 
to  tuberculin.  In  all  such  investigations,  in  order  to 
promote  health  in  cattle  as  well  as  man,  the  opinion  ar- 
rived at  by  the  highest  authority  is,  that  sanitation  ranks 
first.  Dairymen  should  be  registered,  and  an  inspector 
appointed  for  a  specific  area  of  country,  to  be  under  the 
control  iof  the  local  government  or  a  provincial  bureau 
of  cattle  commissioners,  to  make  reports  at  stated  inter- 
vals, as  well  as  issue  printed  circular  directions  to  dairy- 
men, milk  venders  and  cattle  dealers,  for  their  guidance 
and  general  direction,  and  all  animals  for  food  supply 
should  be  inspected  before  they  are  sold.  Some  such 
system  carried  into  effect  in  Canada  would  reduce  tuber- 
culosis to  a  minimum,  and  do  much  to  strengthen  the 
belief  that  the  Dominion  is  a  center  of  health,  happi- 
ness and  prosperity.  Too  much  stress  can  not  be  placed 
on  these  facts,  in  order  that  the  public,  as  a  whole,  may 
be  aroused  to  the  great  importance  of  a  general  knowl- 
edge of  the  subject,  as  such  would  in  time  give  direction 


2  Public  Health  Report  for  1898,  Vol.  zziv,  p.  149. 

3  TrauB.  American  Pub.  Health  Assn. 


to  governmental  and  special  efforts  of  scientists,  who 
should  not  be  single-handed  in  public  health  efforts. 

In  May,  1900,  the  regius  professors  of  Oxford  and 
Cambridge  spoke  with  all  the  responsibility  of  their 
office,  an  the  communicability  of  consumption  and 
its  prevention,  fully  impressed  with  the  fact  that  from 
66,000  to  70,000  die  annually  from  the  disease  in  Great 
Britain,  more  than  double  the  fatality  of  the  entire 
British  force  at  present  in  South  Africa. 

Clifford  Allbutt  epitomized  the  preventive  meas- 
ures: an  active  crusade  against  the  three  D's — damp, 
darkness  and  dirt.  In  clearing  the  public  of  these  evils, 
the  standard  of  general  health  would  be  raised  to  a 
higher  level,  and  what  is  needed  in  Canada  is  thorough 
organization. 

At  the  last  session  of  the  legislature  of  Ontario  a 
permissive  bill  was  unanimously  passed,  the  result  of 
the  labors  of  the  Anti-Consumptive  League,  of  Toronto, 
providing  for  the  erection  and  maintenance  of  a  sana- 
torium for  consumptives  in  each  municipality,  or  group 
of  municipalities,  in  the  Province  of  Ontario.  This  is 
a  most  progressive  move,  in  keeping  with  the  advance- 
ment of  the  day,  and  one  which  reflects  much  credit  on 
the  local  authorities  of  Ontario. 

The  history  of  medical  opinion  as  to  the  communi- 
cability of  tuberculosis  is  somewhat  remarkable.  Ville- 
min  was  ridiculed  as  to  his  ideas  of  infection,  but  we 
are  ail  contagionists  now,  and  Villemin's  name  stands 
out  as  one  of  the  greatest  men  of  his  time,  true  scientist 
in  the  widest  and  most  comprehensive  sense. 

Considering  the  antiquity  of  the  belief  of  contagious- 
ness of  consumption,  it  is  remarkable  the  length  of  time 
that  elapsed  before  active  measures  were  thought  of  to 
stay  the  progress  of  the  disease.  That  consumption  was 
contagious  was  known  to  Aristotle,  who  stated  that  the 
breath  of  consumptives  was  poisonous  to  those  about 
them.  In  the  second  century,  Galen  announced  the 
same  idea,  and  warned  the  people  that  it  was  dangerous 
to  live  intimately  with  sufferers  from  consumption.  In 
the  fifteenth  and  sixteenth  centuries,  Baillon,  a  cele- 
brated French  physician,  and  Montano  observed  the 
frequency  of  consumption  in  those  who  attended  phthis- 
ical patients.  In  1682  the  celebrated  Morga^i  ex- 
pressed the  same  opinion.    At  Nancy,  in  1750,  the  fur- 


6 


niture  of  a  woman  who  died  of  consumption  was  pub- 
licly burnt  by  order  of  the  magistrates.  In  1754  the 
Grand  Duke  of  Tuscany  sought  council  from  the  Flor- 
ence College  of  Physicians  as  to  the  infectiousness  of 
consumption,  and  a  legislative  enactment  for  the  pre 
vention  of  consumption  was  issued  in  1782  by  Frederick 
1\^^.,  King  of  Naples.  Thus,  in  the  medical  history  of 
Europe  we  are  enabled  by  records- to  trace  very  marked 
activity  in  the  line  of  defense  against  the  infectious 
character  of  consumption. 

The  one  great  source  of  contagion  is  the  sputum  of 
the  consumptive  patient,  and  particularly  in  its  dried 
state.  Fortunately,  all  those  who  inhale  or  ingest 
tubercle  germs  do  not  contract  consumption.  Much  de- 
pends on  a  lowered  state  of  the  system,  rendering  it  tit 
soil  for  its  development.  The  surroundings  of  the  indi- 
vidual limit  greatly  the  infectious  character  of  this  dis- 
ease. Much  of  the  immunity  from  consumption  de- 
pends on  the  care,  prudence,  and  v.atchfulness  exercis^ed 
to  promote  a  healthy  state  of  the  system,  and  to  counter- 
act any  disposition  toward  a  lowering  of  normal  vitality, 
by  careful  observation  and  action,  both  as  to  external 
conditions  or  surroundings  and  the  internal  workings 
of  the  system,  the  very  fortifications  set  up  by  nature 
to  guide,  direct,  and  preserve  health. 

AH  interested  in  tuberculosis  should  be  alive  to  the 
fact  that  it  is  a  preventable  disease,  and  as  a  most  de- 
sirable precaution  against  its  spread,  those  laboring  un- 
der the  disease  should  use  a  metal  sputum  cup,  which, 
with  contents,  can  be  thoroughly  boiled,  and  thus  act 
against  infection.  Strict  quarantine  should  be  exer- 
cised against  the  importation  of  foreign  consumptives. 
Connecticut  Medical  Society  Report,  1899,  states: 

"Every  building  where  large  gatherings  frequent  be- 
comes a  source  of  danger,  unless  precautions  are  used, 
for  where  can  a  large  gathering  be  found  that  some  con- 
sumptive does  not  frequent  ?  Theaters,  churches,  school- 
rooms, with  vitiated  air  and  packed  doors,  our  homes 
where  consumptives  live,  the  mill,  the  office,  the  sleep- 
ing car,  hotels  and  cottages,  in  all  health  resorts  where 
consumptives  congregate,  and  even  the  public  telephone 
and  drinking  cup,  may  become  sources  of  infection." 

Ship-owners  should  be  careful  that  berths  holding 
several  passengers  should  not  have  even  one  of  these 


ii 


\l 


consumptivps.  Once  our  people  are  aroused  to  the  fact 
that  thousands  die  annually  who  might  have  been  saved 
by  preventable  means,  then  timely  care  will  be  taken, 
and  the  necessary  measures  carried  out,  to  reduce  the 
death-rate  to  the  smallest  margin  possible. 

As  to  the  medical  treatment,  the  opinion  now  prevails 
that  we  have  no  specific  for  consumption.  Dr.  Boding- 
ton,  of  Sutton  Coldfield,  England,  was  the  first  to  ad- 
vocate the  o])en-air  treatment  of  consumption,  and  in 
this  line  of  action  Dr.  Henry  Bennet,  Edinburgh,  advo- 
cated vigorously  the  open-air  treatment  in  the  Riviera. 
To  th'  fresh-air  life,  liberal  feeding  was  added,  the 
free  adn»..Jstration  of  cod-liver  oil,  and  in  this,  Hughs- 
Bennct  was  quite  noted. 

The  Adirondack  cottage  sanatorium  for  the  treatment 
of  incipient  pulmonary  tuberculosis,  under  Dr.  Trudeau, 
has  accomplished  much  good  and  practical  work.  In 
round  numbers,  the  result  from  all  sanatorium  treatmont 
is  estimated  at  about  one-third  cured  of  those  who  re- 
mained a  reasonable  term,  from  three  to  nine  months ; 
and  what  can  be  more  satisfactory  than  the  fact  that 
absolute  cures  do  occur? 

Marked  increased  activity  is  evident  b^  the  congresses 
held  in  various  parts  of  the  world.  Last  year  Berlin 
had  a  most  successful  meeting,  at  which  Canada  was 
represented  by  Dr.  Farrel,  of  Halifax,  to  whom  we  are 
indebted  for  an  excellent  report.  This  ye&\  Naples  has 
done  likewise,  and  next  year  a  congress  will  be  held  in 
Tjondon,  under  the  presidency  of  H.  R.  H.  the  Prince  of 
Wales. 

If  we  inquire  into  the  practical  outcome  so  far,  we 
will  find  that  many  able  speeches  have  been  delivered, 
much  enthusiasm  excited,  resolutions  passed,  associa- 
tions formed,  and  the  state  called  on  to  provide  the 
requisite  machinery  for  carrying  out  the  necessary  san- 
itary measures.  Lord  Salisbury  in  1898  said:  "You 
must  be  content  with  preaching  the  salutary  doctrine 
you  hold,  and  must  not  think  of  applying  it  with  the 
secular  arm."  So  now,  in  England,  the  protection  of 
the  people,  in  these  matters  of  health,  actually  rests 
with  the  municipal  and  local  authorities.  In  Italy, 
fortunately,  matters  are  somewhat  different.  Professor 
Baccelli,  who  is  also  an  authority,  as  statesman  and 
scientist,  and  as  president  of  the  Congress  at  Naples,  an- 


8 


nouncjed  that  the  Italian  government  prepared  a  law 
concerning  the  prophylaxis  of  infectious  diseases,  in 
which  tuberculosis  figures  conspicuously.  Persuasion 
alone  is  not  sufficient,  but  compulsion  must  be  used. 
W.e  shall  look  forward  with  much  interest  to  the  out- 
come of  this  progressive  measure,  under  the  guidance  of 
so  eminent  an  authority.  The  education  of  our  people 
in  methods  necessary  to  counteract  the  spread  of  tuber- 
culosis would  assist  materially  all  other  efforts  in  the 
same  direction  Efforts  should  be  made  by  the  school, 
the  church,  the  councils,  and  in  every  way  possible,  to 
inform  the  masses  as  to  the  vast  moment  of  this  serious 
malady,  and  as  to  the  manner  in  which  their  united  co- 
t  peration  would  prove  of  service. 

Tuberculosis  has  become  a  really  national  disease,  and 
is  widely  spread.  The  Provincial  Bureau  of  Public 
Health  doubtless  will  have  an  increased  appropriation 
and  additional  special  experts  on  this  disease,  that  every 
means  should  be  taken  to  stay  the  progress  of  tubercu- 
losis, without  which  our  efforts  would  be  futile  and  the 
results  anything  but  satisfactory. 

A  central  bureau  of  health  can  not  be  thoroughly 
equipped  without  a  chemical  and  bacteriological  labora- 
tory. Such  are  indispensible  in  the  present  advanced 
state  of  science. 

The  Dominion  of  Canada  indicates  a  vigorous  and 
healthy  growth  in  this  direction.  Meetings  like  the 
present  tend  to  strengthen  and  develop  the  power  of 
public  opinion  ih  aid  of  the  cause  of  science,  and  we 
trust  that  by  jur'^'cious  enterprise  and  intelligent  energy 
the  practical  result  will  be  that  the  soil  and  bacilli  of 
tuberculosis  will  rapidly  disappear. 

150  Elgin  Street.  Ottawa. 


CHICAGO 
AvmicAN  Mbmcal  Association  Phebs 
1900 


